title: Angiographic circulation time and cerebral blood flow during balloon test occlusion of the internal carotid artery.
abstract: Angiography-based balloon test occlusion (BTO) has been empirically used to predict tolerance to permanent carotid artery occlusion. We tested the hypothesis that the laterality of the hemispheric circulation time (HCT) of the contrast medium at cerebral angiography would reflect bilateral asymmetry of the cerebral blood flow (CBF) during BTO. Thirty-one consecutive patients who underwent BTO of the internal carotid artery were retrospectively analyzed. HCT was defined as the interval between the time-to-peak in the middle cerebral artery and the cortical veins calculated using time-density curve. The difference in HCT between the occluded and nonoccluded side was calculated at the carotid or dominant vertebral angiograms obtained during BTO. We estimated the correlation between the difference in HCT and bilateral asymmetry of the CBF, which was quantitatively determined by single-photon emission computed tomography. The HCT was 5.3±1.5 seconds and regional CBF was 41.3±11.3 mL/100 g per minute in the occluded side, compared with 3.6±0.9 seconds and 48.4±14.9 mL/100 g per minute in the nonoccluded side, respectively. The difference in HCT was strongly correlated with the asymmetry ratio of the CBF (r(2)=0.89, P<0.0001). Angiographically based measurement of the cerebral circulation time can provide valuable information concerning cerebral hemodynamics.
authors.affiliation: Department of Neurosurgery, Tohoku University, Graduate School of Medicine, Sendai, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sato
authors.affiliation: Department of Neurosurgery, Tohoku University, Graduate School of Medicine, Sendai, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimizu
authors.affiliation: Department of Neurosurgery, National Hospital Organization, Sendai Medical Center, Sendai, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Inoue
authors.affiliation: Department of Neurosurgery, Tohoku University, Graduate School of Medicine, Sendai, Japan.
authors.forename: Miki
authors.initials: M
authors.lastname: Fujimura
authors.affiliation: Department of Neuroendovascular Therapy, Sendai, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Matsumoto
authors.affiliation: Department of Neuroendovascular Therapy, Sendai, Japan.
authors.forename: Ryushi
authors.initials: R
authors.lastname: Kondo
authors.affiliation: Department of Neurosurgery, Kohnan Hospital, Sendai, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Endo
authors.affiliation: Department of Neurosurgery, Tohoku University, Graduate School of Medicine, Sendai, Japan.
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Sonoda
authors.affiliation: Department of Neurosurgery, Tohoku University, Graduate School of Medicine, Sendai, Japan.
authors.forename: Teiji
authors.initials: T
authors.lastname: Tominaga
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021721:Balloon Occlusion / Q000379:methods*; D001783:Blood Flow Velocity / Q000502:physiology*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D002533:Cerebral Angiography; D002560:Cerebrovascular Circulation / Q000502:physiology*; D004292:Dominance, Cerebral; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome